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�--- — - -- - <br />ELECTRIGAL PERMIT APPLICATiON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.arg <br />�'�f �Cl �ve✓y��c �� �u,� 2U�e�!ef�" �� °5 <br />—r- � ��-�-- <br />PROJECT ADDRESS <br />Owner <br />R r,,, <br />� <br />Tenant <br />i�� l�l�rGK <br />� Electrical <br />Po1ad AtlCress <br />o e��� <br />Fdad Atldress <br />f��(��_ lij%� <br />h1a� �ddress � � <br />��.�� K S� �2�1 �"� —' <br />Sta;e License Number (required) <br />� � SI�Gv�% <br />Prcposed Use of Building <br />Gry <br />I 38u 3zv � <br />Square �oolage (If residential new construclion, remodel or addi�ion) <br />Number of devices Q( lo�v vollage) <br />0 <br />Description of Work to Be Done: <br />L`CL'��/�� � 0!,(� f'� �'' <br />�iv v G0� �, Z�l i <br />I✓ ot a� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cdy <br />�i <br />StatclZ�p Phcre �i <br />��i� Z oG-yS l ��� �7 <br />Slatci7_Ip Phone �� <br />- q�o 36 20�, 55o i� <br />SlatelZlp Phone <br />City ot Evere�t Busmess License Number (required) <br />�v� <br />� Contrect Price o( Work <br />�ru�G�on I'�,��e/ zoG-350 � ��l � d _ <br />Contacl Person/ ontact Numbed[mad �, <br />�/Ait��n �C'l3l�tLf1 f��t c'�G'/c�� (i� <br />�/t✓ WuI/ iL'�J(/tl � %iC%7 S�✓,Izlj�l� <br />1 hr.rehy certdy that I have read and exarnined (his application and kno:v fhe same fo be (rue and <br />correct. All provisions ollaws and o�dinances goveming fhis type ol �eork �ti�ill be completed <br />ivhether specilied he�ein or noL The granting o/ a pemiif does not p�esume fo give aufhonfy to <br />violate or cancel fhe provisions ol any other state or locaf la�v regulating conshuction or the <br />peAonnance o(consVuc(ion. That I am authonzed by lhe owner oRhis property lo peAomi the <br />�vork !or ivhich applicalion is made and 1 compty r✓illr fhe Sfate Contracfo�s Law 1B.27 RCW and <br />2B6 200 WFlC. <br />�:evrs�c c� � =::ui� <br />F[E __ <br />(��•�d <br />PERh1fi �: <br />E (�o� - D�� <br />